Coping Strategies for Addiction Recovery and Homelessness

Publication Date

Spring 5-29-2024

Item Type


Executive Summary

Coping Strategies for Addiction Recovery and Homelessness

The city of Seattle has roughly 14,000 individuals experiencing homelessness (U.S. Department of Housing and Urban Development, 2023). In 2023, there were 1,338 overdose deaths within King County, which is a 32.7% increase from the previous year, 2022 (King County, 2024). Considering these numbers, there is an addiction recovery café near South Lake Union in Seattle that seeks to provide a place of solace and rehabilitation for people with varying backgrounds and challenges. They focus on providing hope, help, and wellness to those recovering from many various addictions, homelessness, trauma, or a mix thereof. The center serves coffee and two meals on six days of the week, hosts the twelve-step program, and facilitates their members participation in recovery circles. Recovery circles are a form of group therapy that gives them a place to discuss their struggles and build trust in their community.

A group of six nursing students from Seattle Pacific University were assigned to this recovery center and asked to create a project that will benefit this community population. The group noticed that the community members consistently reported a need for healthy coping mechanisms to help manage their stress and loneliness outside of their time spent at the café (or center). The group decided to focus their efforts on the introduction of new, healthy coping mechanisms to help the community manage their stress and loneliness.


Instead of focusing on only substance abuse, this recovery center brings a more holistic approach to the recovery process by providing community resources on top of individual services. These include support groups for recovery and basic needs, family and housing assistance, education assistance, testing and treatment referrals, and a social environment with sober activities (Owens et al., 2022).

Within the population of people that attend this café, the group found that 50% experience homelessness and a large portion suffer severe trauma in their lives that has led them to addiction. The Substance Abuse and Mental Health Service Administration found that 38% of homeless people abuse alcohol and 26% abuse other substances (American Addiction Centers, 2024). A review of the literature further demonstrated that traumatic experiences decrease one’s internal and external resources and lead to dysfunctional physiological reactions. These reactions negatively affect one’s coping mechanisms and emotional regulation (Wiewel & Hernandez, 2021).

Café members reported that they felt supported and stable while present at the café, however, when they left, they reported recurring feelings of loneliness and depression. Considering these statistics and our findings, the group chose to address the issue of negative coping mechanisms. Our team’s focused on a nursing diagnosis of ineffective coping related to depression and loneliness secondary to social isolation, houselessness, and lack of education. This is evidenced by subjective statements of loneliness outside the café among members. These statements were gathered from members and staff.

Activities with Rationale

Interventions were then created to bolster positive coping mechanisms to counter depression and loneliness. These activities were intentionally designed to be low stakes, yet impactful. Our primary intervention involves educating individuals on mindfulness-based coping strategies such as visualization, box breathing, and body scan meditation. Mindfulness-based techniques were selected due to their demonstrated efficacy, particularly in aiding individuals with addiction issues. Research suggests that addressing loneliness and fostering mindfulness could enhance treatment retention and mitigate the risk of relapse and overdose among individuals struggling with opioid use disorder (Herczyk et al., 2023).

Moreover, alongside mindfulness-based techniques, the group introduced crisis coping cards as a resource to combat suicidal tendencies, depression, anxiety, and hopelessness. A randomized controlled study has highlighted the significant reductions in subsequent suicidal behaviors and the severity of suicide risk, alongside improvements in depression and anxiety, attributed to the integration of crisis coping cards (Wang et al., 2016). Notably, most café members that utilize these coping cards experienced a healthier coping mechanism, leading to reductions in depression, loneliness, and anxiety, and an increase in their willingness to engage in conversations. This underscores the vital role of tangible coping resources in supporting individuals during moments of acute distress (Wang et al., 2016). Thus, integrating both mindfulness education and crisis coping strategies into our intervention plan provides a comprehensive approach to enhancing mental well-being and resilience.

Lastly, our group planned to incorporate blood pressure checks as part of our continuous quality improvement (CQI) strategy after week one. By offering blood pressure checks at our booth, café members were encouraged to engage with our interventions. This served as an initial point of contact, enticing individuals to visit our booth and become receptive to our interventions. Moreover, it created an opportunity for us to provide guidance and resources to those interested in learning more about managing their blood pressure. This also allowed us a good opportunity for our group to educate individuals about stress management and healthy coping strategies, especially when they are experiencing loneliness or isolation outside the café. By engaging with individuals during the blood pressure checks, the group can initiate conversations about stress and provide them with education and techniques for managing it effectively. The nursing students also evaluated the utilization of mindfulness exercises and coping cards outside the café, offering additional support and encouragement.


During the project, the group sought to improve the coping mechanisms of the population within the recovery center. To make progress towards this vision, the group used the logic model to set multiple output and outcome goals and objectives. The first of these goals was that on each day that the group held the intervention, at least six people would interact with our activities. The group was able to meet this outcome goal. Six people participated in the interventions during week one, nine people during week two, and seven people during week three. The other outcome goal the group set was that multiple members each week would report a plan to use coping strategies in everyday life. The group noticed a general consensus among the members who participated in our interventions that mindfulness strategies would be useful in reducing their stress and anxiety in everyday life. The group’s overall, long-term population impact goal was that members would eventually exhibit fewer signs and symptoms of depression and loneliness while utilizing more positive coping strategies in everyday life. The group was unable to assess this goal in the limited timeline in which the project was performed. This would be a good topic for future nursing students to review to assess for change in the population.


Minimal support outside of the café was a common concern expressed by many of the members. Members reported heightened struggles with stress, loneliness, and maladaptive coping once they left the café. The team focused on promoting healthy coping mechanisms through mindfulness-based techniques that could be easily implemented outside of the café setting. The mindfulness-based interventions implemented by the team included crisis coping cards, boxed breathing, and body scan exercises. Promoting these mindfulness-based techniques addressed stress and maladaptive coping and helped members implement healthy coping strategies outside of the café.


American Addiction Centers. (2024). Substance abuse and homelessness: Statistics and rehab treatment.

Herczyk, J. M., Zullig, K. J., Davis, S. M., Mallow, J., Hobbs, G. R., Davidov, D. M., Lander, L. R., & Theeke, L. (2023). Association of loneliness and mindfulness in substance use treatment retention. International Journal of Environmental Research and Public Health, 20(16), 6571.

King County. (2024). Overdose data dashboards. Public Health, Seattle and King County. prevention/overdose-prevention-response/data-dashboards

Owens, M. D., Banta-Green, C. J., Newman, A., Marren, R., & Takushi, R. (2023). Insights into a recovery community center model: Results from qualitative interviews with staff and member facilitators from Recovery Café in Seattle, Washington. Alcoholism Treatment Quarterly, 41(1), 62–75.

U.S. Department of Housing and Urban Development. (2023). Office of Community Planning and Development. The 2023 annual homelessness assessment report to Congress.

Wang, Y. C., Hsieh, L. Y., Wang, M. Y., Chou, C. H., Huang, M. W., & Ko, H. C. (2016). Coping card usage can further reduce suicide reattempt in suicide attempter case management within 3-month intervention. Suicide & Life-Threatening Behavior, 46(1), 106–120.

Wiewel, B., & Hernandez, L. (2022). Traumatic stress and homelessness: A review of the literature for practitioners. Clinical Social Work Journal, 50(2), 218-230.

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